Diagnostics

State Of The Art Testing

Infection

Infection can play a role as the underlying cause of many diseases including chronic fatigue, fibromyalgia, arthritis, and even psychiatric disorders. Testing for infections may not only include acute causes of illness, but also detection of the presence of chronic infections. Some of the infections known to be associated with chronic disease include:

  • Streptococcus
  • pneumonaie
  • HHV-6
  • Epstein Barr Virus
  • Bartonella
  • Babesia
  • Ehrlichia/anaplasma
  • Mycoplasma Pneumonaie
  • Borellia Burgdorferi
  • Streptococcus Pneumonaie 

Lyme Disease Testing

It is important to understand the nature of Borellia burgdorferi – the bacteria responsible for Lyme – in order to also understand the difficulty in diagnosing Lyme disease. This bacteria has many ways to avoid destruction and detection, making diagnosis complicated.

Diagnosing Lyme disease requires a combination of lab testing and clinical evidence (your symptoms etc.). There is no “one best test” to determine the presence of infection.

Most often combinations of tests are utilized to get the most accurate diagnosis. The most common are;

  • IFA or ELISA: These tests look for antibodies that your system creates in response to an infection. Unfortunately, these tests are not very sensitive and may miss up to 80% of those infected. These tests are not effective in ruling out Lyme disease.
  • Western Blot: This test uses a different technique to look for antibodies, sorting them by numbered bands. This test may miss up to 30% of those infected, and has a long and political history. The accuracy of the Western Blot is somewhat determined by what lab performs the test because certain bands are left out of the standard tests used in Canada and the United States. The bands in question are highly specific to Borrelia, and it is important to use a lab that looks for them. This is the second of the two-stage process in the United States and Canada.
  • Cytokine test: Cytokines are another immune system marker, and Borrelia activates specific cytokines that can be detected in the blood. This test is used in people who have not produced antibodies.
  • PCR: This test looks for the DNA of the Borrelia organism rather than indirect signs such as antibodies. The trouble is that it requires a physical trace of the bacteria in the blood sample. This test is also used when checking ticks for infection. In that case the lab mashes up the entire tick, so it is impossible to miss any trace of the Borrelia. If you have a tick you would like tested, contact us and we will send it to the appropriate lab.
  • Urine Antigen: If the Western Blot test is inconclusive it may be necessary to do an antibiotic challenge and perform a urine antigen test, which looks for traces of the Borrelia in the urine. Again the limitation is that the sample has to contain physical traces of the bacteria.
  • CD57: This test is helpful in identifying the presence and relative severity of Borrelia infection by looking for signs of Natural Killer cells. As the infection is better controlled with treatment the CD57 will increase back within normal range.
  • Elispot: New generation of diagnostic test for the detection of memory T cells that respond to stimulation by Borrelia burgdorferi This testing uses an enzyme-linked immunospot technology to count B. burgdorferi-sensitized T cells. The test is useful both for the early detection of infection before antibodies are produced, and in chronic infection when antibody production has been suppressed.
  • Co-infections: When a person is bit by a tick they are not only at risk of contracting Lyme disease, but also a number of other infections carried by ticks commonly referred to as “co-infections”. This includes testing for the following organisms:
    • Babesia
    • Bartonella
    • Ehrlichia
    • Anaplasma
    • Rickettsia

Lyme tests provide us with important information. Our Calgary naturopathic doctors help to interpret this information and combine it with clinical symptoms to make the appropriate diagnosis. Along with the main Lyme tests there is some testing that is required to ensure your body is functioning as well as it can before, during, and after treatment. A variety of tests for hormone, digestive and organ function, allergies, and others are an integral part of beating Lyme disease or any other chronic condition. As you have no doubt noticed, many of the above tests have significant drawbacks, and a combination of them is often required. Even the Western Blot, which is the most useful test available if the proper bands are included, has limitations. There is new testing on the horizon that may change the way Lyme is diagnosed, but for now the most important aspect for getting an accurate diagnosis is seeing a doctor who is trained to put your history and symptom puzzle together.

What are your symptoms? Where have you lived and traveled? What other diagnoses have you had? How many tick attachments? How many members of your family have Lyme disease? The answers to these questions – and others – add up to something when the right person is listening. The naturopathic doctors of the Nardella Clinic in Calgary are members of ILADS (International Lyme and Associated Diseases Society), and have many years of experience diagnosing and treating complex disease, including a significant number of Lyme patients. We have a keen interest in using the best methods and information available to diagnose and treat your whole body.